Symptom Duration of One Year or More Is Associated With Worse Absolute Outcomes but Similar Clinically Meaningful Improvement After ACDF for Cervical Myelopathy.
Longer preoperative symptom duration linked to lower 3-month physical function scores after anterior cervical discectomy and fusion.
Symptom Duration of One Year or More Is Associated With Worse Absolute Outcomes but Similar Clinically Meaningful Improvement After ACDF for Cervical Myelopathy.
Prior studies suggest longer duration of preoperative myelopathic symptoms may impair neurologic recovery after surgery, but its relationship with patient-reported outcome measures (patient-reported outcome measures) and clinically meaningful improvement remains unclear.
To evaluate the association between preoperative symptom duration and neurologic and patient-reported outcomes after anterior cervical discectomy and fusion (anterior cervical discectomy and fusion) for degenerative cervical myelopathy (degenerative cervical myelopathy).
Were stratified by symptom duration (<1 y vs. ≥1 y).
A total of 139 patients met inclusion criteria, including 75 (54.0%) with symptom duration <1 year.
Patients with <1 year of symptoms were older, less likely to have commercial insurance, less likely to undergo inpatient surgery, and underwent fusion of fewer levels.
Visual Analog Scale Neck and Neck Disability Index scores were lower at select postoperative time points in the <1-year cohort.
The ≥1-year cohort demonstrated higher rates of minimal clinically important difference achievement for Visual Analog Scale Neck at 6 and 12 months.
Longer preoperative symptom duration was associated with worse absolute postoperative pain and disability but not neurologic recovery, with largely comparable rates of minimal clinically important difference achievement after anterior cervical discectomy and fusion.
These findings suggest that delayed presentation does not preclude meaningful postoperative improvement for cervical myelopathy. LEVEL OF EVIDENCE: Level III.